Universal Health Insurance: A Right Or Privilege?
“Disease, sickness and
old age touch every family. Tragedy doesn’t ask who you voted for. Health care
is a basic human right.”- Senator Elizabeth Warren
Successive governments over the years have spoken about universal health insurance for all Jamaicans; sadly, nothing has been done to bring this into reality. We live in a time when more and more people are living beyond three scores and ten. Advances in medical sciences have facilitated the average life expectancy age to increase in many societies. However, with longevity comes the possibility of non-communicable diseases such as hypertension, diabetes, cardiovascular diseases, asthma and cancers. According to the Ministry of Health, non-communicable diseases are a major public health burden in Jamaica. In 2015, an estimated seven out of ten Jamaicans died from the four major NCDs, cancer, cardiovascular disease, diabetes and chronic lower respiratory disease. A World Bank report states that non-communicable diseases (NCDs) not only adversely impact quality of life through morbidity and mortality, but also imposes an economic burden on households and on society as a whole. The direct economic burden at individual level is the sum of out of pocket spending by patients with NCDs on outpatient and inpatient care and on medication. The indirect economic burden comes from loss of income due to work absenteeism associated with illness. The report goes further by estimating that an individual suffering from NCD spends approximately one third of household per capita expenditure on healthcare services and purchase of pharmaceutical drugs. National aggregate out of pocket health expenditure amounted to JM$33, 813 million or 3.08 percent of Jamaica’s Gross Domestic Product (GDP).
Non- Communicable Diseases
Non-communicable diseases are a threat to national security and should be viewed as such in order for policy makers to become more proactive in managing this danger. A related health concern is that of Chronic Kidney Disease (CKD). This health condition has a deep association with the poor health outcomes of non-communicable diseases such as hypertension and diabetes. It is estimated that 850 million people worldwide have kidney diseases from various causes, among that number is my dad Fitzroy who was diagnosed with stage 4 kidney disease in August of 2018. According to the World Kidney Disease website, Chronic Kidney Disease (CKD) is responsible for at least 2.4 million deaths per year and is now the 6th fastest growing cause of death globally. The same source reports that despite the growing burden of kidney diseases globally, kidney health disparity and inequality are still widespread. Sadly, about 1.7 million people die annually from Acute Kidney Injury (AKI) with 85 percent of those individuals coming from low to middle- income countries. Social conditions such as poverty, gender discrimination, lack of education, occupational hazards and pollution often adds to the challenges for those who are affected by Chronic Kidney Disease and Acute Kidney Injury. Additionally, the same social conditions also affect the care-givers for those patients of kidney disease. In many instances family members are required to take time off from work to attend to the medical needs of their loved ones. There are many employers who are sympathetic; however, many others are not so generous in this regard. According to the World Health Organization (WHO), non-communicable diseases (NCDs) are also known as chronic diseases and they tend to be of long duration, and are a result of a combination of genetics, physiological, environmental and behavior factors. According to the WHO these NCDs are driven by forces that include rapid unplanned urbanization, globalization of unhealthy lifestyles and population ageing. Needless to say people are suffering. Sub-groups in the society tend to bear the brunt of this suffering. This suffering is magnified due to the fact that most of our population especially the vulnerable has no form of health insurance. According to the Report of the Secretary –General, The Sustainable Development Goals Report 2018 globally, at least 32 million people died in 2016 from cardiovascular diseases, cancers, diabetes or chronic respiratory disease. The same source reported that globally, almost 12 per cent of the world’s population or 800 million people spent at least one tenth of their household budgets to pay for health care services. Many families suffer immensely due to the burgeoning cost of health care due to doctors’ visits, diagnostic tests and prescription. In fact some families can go bankrupt due to the health care costs in societies which do not have universal health care. The time has come for the government to have a conversation with its major stakeholders in an effort to arrive at a consensus regarding how to implement and fund a universal health insurance policy for all Jamaicans. The United Nations Sustainable Development Goal #3 speaks to ensuring healthy lives and the promotion of well-being for all at all ages. Undoubtedly, a critical aspect of this SDG must be the health care coverage of the citizenry in our society. The World Health Organization (WHO) states that universal healthcare is a healthcare system that allows the citizens of a particular country to access medical services without bearing the burden that comes with the service. Additionally, the WHO defines the universal health coverage as means where the public can access the promotive, preventative, rehabilitative and curative health service sufficiently and efficiently while ensuring that they are not exposed to financial hardship. The main advantage of universal healthcare is that more people can access better healthcare which undeniably leads to a healthier nation. The WHO states, the universal health coverage does not only improve health, it reduces poverty, creates jobs, drives inclusive economic growth, promotes gender equality and protects populations from epidemics. Interestingly, the United Nations is advocating for a universal healthcare system for all its members by 2030. In other words universal health coverage is a tool for development, prosperity and growth.
Funding for Universal Health Insurance
Jamaica will not be able to maximize its full growth potential and develop if we do not put in place a comprehensive health care insurance scheme to address the needs of the population. A society which takes care of its most vulnerable is a progressive society. There are many universal health insurance models from which Jamaica can borrow aspects from in crafting her own universal health insurance. According to WorldAtlas.com there are fifty eight countries with universal health care. Among the countries having universal healthcare are Belgium, Canada, Brazil, Denmark, Australia, Norway, Slovenia (with a population under 3 million people) and Israel. Costa Rica with a population of under 5 million people also has universal healthcare Kenya in December of 2018 launched a series of pilot programmes for universal health coverage. In Germany the citizens contribute approximately 13% of gross earnings to any of the more than 300 statutory state sickness funds. The unemployed are funded through the social fund. Belgium has one of the best healthcare systems in the world. The universal health care system in Belgium is sponsored by competing mutuals by state run hospitals and non-profit hospitals. Each mutual is funded by the government depending on its membership.
What a lasting legacy this would be for generations of Jamaicans. As a society we call upon our politicians to re-commit themselves in ensuring that we implement universal health insurance coverage for all. Access to health care is a human right. Too many Jamaicans are outside of the safety net that health insurance provides. Too many families suffer when the breadwinner of that family becomes ill. Disturbingly, the World Health Organization states that 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. It is time Jamaica join the ranks of those countries which provide universal health insurance for their citizens.
As the psalmist David wrote in Psalm 71 and verse 9, do not cast me off in the time of old age, forsake me not when my strength is spent.
@WayneCamo
#WorldHealthDay
#HealthForAll
Successive governments over the years have spoken about universal health insurance for all Jamaicans; sadly, nothing has been done to bring this into reality. We live in a time when more and more people are living beyond three scores and ten. Advances in medical sciences have facilitated the average life expectancy age to increase in many societies. However, with longevity comes the possibility of non-communicable diseases such as hypertension, diabetes, cardiovascular diseases, asthma and cancers. According to the Ministry of Health, non-communicable diseases are a major public health burden in Jamaica. In 2015, an estimated seven out of ten Jamaicans died from the four major NCDs, cancer, cardiovascular disease, diabetes and chronic lower respiratory disease. A World Bank report states that non-communicable diseases (NCDs) not only adversely impact quality of life through morbidity and mortality, but also imposes an economic burden on households and on society as a whole. The direct economic burden at individual level is the sum of out of pocket spending by patients with NCDs on outpatient and inpatient care and on medication. The indirect economic burden comes from loss of income due to work absenteeism associated with illness. The report goes further by estimating that an individual suffering from NCD spends approximately one third of household per capita expenditure on healthcare services and purchase of pharmaceutical drugs. National aggregate out of pocket health expenditure amounted to JM$33, 813 million or 3.08 percent of Jamaica’s Gross Domestic Product (GDP).
Non- Communicable Diseases
Non-communicable diseases are a threat to national security and should be viewed as such in order for policy makers to become more proactive in managing this danger. A related health concern is that of Chronic Kidney Disease (CKD). This health condition has a deep association with the poor health outcomes of non-communicable diseases such as hypertension and diabetes. It is estimated that 850 million people worldwide have kidney diseases from various causes, among that number is my dad Fitzroy who was diagnosed with stage 4 kidney disease in August of 2018. According to the World Kidney Disease website, Chronic Kidney Disease (CKD) is responsible for at least 2.4 million deaths per year and is now the 6th fastest growing cause of death globally. The same source reports that despite the growing burden of kidney diseases globally, kidney health disparity and inequality are still widespread. Sadly, about 1.7 million people die annually from Acute Kidney Injury (AKI) with 85 percent of those individuals coming from low to middle- income countries. Social conditions such as poverty, gender discrimination, lack of education, occupational hazards and pollution often adds to the challenges for those who are affected by Chronic Kidney Disease and Acute Kidney Injury. Additionally, the same social conditions also affect the care-givers for those patients of kidney disease. In many instances family members are required to take time off from work to attend to the medical needs of their loved ones. There are many employers who are sympathetic; however, many others are not so generous in this regard. According to the World Health Organization (WHO), non-communicable diseases (NCDs) are also known as chronic diseases and they tend to be of long duration, and are a result of a combination of genetics, physiological, environmental and behavior factors. According to the WHO these NCDs are driven by forces that include rapid unplanned urbanization, globalization of unhealthy lifestyles and population ageing. Needless to say people are suffering. Sub-groups in the society tend to bear the brunt of this suffering. This suffering is magnified due to the fact that most of our population especially the vulnerable has no form of health insurance. According to the Report of the Secretary –General, The Sustainable Development Goals Report 2018 globally, at least 32 million people died in 2016 from cardiovascular diseases, cancers, diabetes or chronic respiratory disease. The same source reported that globally, almost 12 per cent of the world’s population or 800 million people spent at least one tenth of their household budgets to pay for health care services. Many families suffer immensely due to the burgeoning cost of health care due to doctors’ visits, diagnostic tests and prescription. In fact some families can go bankrupt due to the health care costs in societies which do not have universal health care. The time has come for the government to have a conversation with its major stakeholders in an effort to arrive at a consensus regarding how to implement and fund a universal health insurance policy for all Jamaicans. The United Nations Sustainable Development Goal #3 speaks to ensuring healthy lives and the promotion of well-being for all at all ages. Undoubtedly, a critical aspect of this SDG must be the health care coverage of the citizenry in our society. The World Health Organization (WHO) states that universal healthcare is a healthcare system that allows the citizens of a particular country to access medical services without bearing the burden that comes with the service. Additionally, the WHO defines the universal health coverage as means where the public can access the promotive, preventative, rehabilitative and curative health service sufficiently and efficiently while ensuring that they are not exposed to financial hardship. The main advantage of universal healthcare is that more people can access better healthcare which undeniably leads to a healthier nation. The WHO states, the universal health coverage does not only improve health, it reduces poverty, creates jobs, drives inclusive economic growth, promotes gender equality and protects populations from epidemics. Interestingly, the United Nations is advocating for a universal healthcare system for all its members by 2030. In other words universal health coverage is a tool for development, prosperity and growth.
Funding for Universal Health Insurance
Jamaica will not be able to maximize its full growth potential and develop if we do not put in place a comprehensive health care insurance scheme to address the needs of the population. A society which takes care of its most vulnerable is a progressive society. There are many universal health insurance models from which Jamaica can borrow aspects from in crafting her own universal health insurance. According to WorldAtlas.com there are fifty eight countries with universal health care. Among the countries having universal healthcare are Belgium, Canada, Brazil, Denmark, Australia, Norway, Slovenia (with a population under 3 million people) and Israel. Costa Rica with a population of under 5 million people also has universal healthcare Kenya in December of 2018 launched a series of pilot programmes for universal health coverage. In Germany the citizens contribute approximately 13% of gross earnings to any of the more than 300 statutory state sickness funds. The unemployed are funded through the social fund. Belgium has one of the best healthcare systems in the world. The universal health care system in Belgium is sponsored by competing mutuals by state run hospitals and non-profit hospitals. Each mutual is funded by the government depending on its membership.
What a lasting legacy this would be for generations of Jamaicans. As a society we call upon our politicians to re-commit themselves in ensuring that we implement universal health insurance coverage for all. Access to health care is a human right. Too many Jamaicans are outside of the safety net that health insurance provides. Too many families suffer when the breadwinner of that family becomes ill. Disturbingly, the World Health Organization states that 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. It is time Jamaica join the ranks of those countries which provide universal health insurance for their citizens.
As the psalmist David wrote in Psalm 71 and verse 9, do not cast me off in the time of old age, forsake me not when my strength is spent.
Wayne Campbell is
an educator and social commentator with an interest in development policies as
they affect culture and/or gender issues.
@WayneCamo
#WorldHealthDay
#HealthForAll
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